About the University

Bench to bedside (continued)

A new Institute of Cancer Medicine will open in 2008 in a building opposite Oxford Radcliff e Hospitals’ new £100 million cancer care centre on the Churchill Hospital site. The Institute will have an explicit focus on translating research into candidate treatments, says David Kerr, Rhodes Professor of Clinical Pharmacology and Cancer Therapeutics. ‘People like me, who are trained in clinical science, have one foot in the clinic and one in the lab. The idea is to take ideas from the lab to the patient’s bedside and go back again – that’s a virtuous loop, a cycle that you can create.’

His own research, designed to exploit genetic differences between cancer cells and normal cells, provides a good example of this approach. Professor Kerr’s colleague Dr Nick La Thangue has discovered some mechanisms in the cancer cell that might potentially be vulnerable to new drug treatments. ‘It’s logical to see if we can develop some agents that might prevent that pathway from working’, says Professor Kerr. ‘We’ve also got antibodies to the target protein. That means that rather than just treating patients and hoping it works, we can select patients and predict whether or not the drug will be effective. This is a powerful exemplar of how we can take something all the way from basic cell biology into chemistry and into very sophisticated clinical trials that themselves feed back into the laboratory.’ The same bench-to-bedside approach informs Professor Adrian Harris’s well-established research programme, looking at ways of asphyxiating tumours by preventing them from developing new blood vessels.

At the Oxford Centre for Clinical Magnetic Resonance Research (OCMR) a volunteer undergoes a cardiac MRI (magnetic resonance imaging) scan. Oxford’s new Biomedical Research Centre brings together researchers, such as those at the OCMR, and clinicians with the aim of delivering more effective treatment to patients.

The Institute of Cancer Medicine will include Professor Gillies McKenna’s Radiation Biology and Oncology research group, which is examining genetic factors that make cancer cells resistant to radiotherapy, and using that knowledge to make them more sensitive so that smaller and more focused doses can be used. The international Ludwig Institute of Cancer research has also moved its UK branch from London to Oxford under Professor Xin Lu. Her research complements the work of both Professor Kerr and Professor McKenna, as she is interested in the molecular pathways that play a role in determining whether a cancer cell lives or dies.

Other themes for the BRC include heart disease, women’s health, genetics, infection, immunology and vaccines, all areas in which Oxford has established both an international reputation and interactions between the research base and clinical care. The BRC provides an infrastructure that ensures that such interactions are extended and supported across the University and the healthcare system. ‘The idea is to increase collaboration between the two’, says Professor Buchan, ‘and to help them to align their research objectives.’ He recognizes that in even in hospitals with a strong research focus, such as the John Radcliffe and the Churchill, the need to meet targets for providing treatment can squeeze out the time and resources for research. Meanwhile, University researchers produce lots of ideas, but there is a bottleneck in getting those ideas to the point where the concept can be tested in real patients. The object of the BRC is to bridge that gap, providing resources to increase the flow of ideas to the clinic and ensure that they are implemented in a manner that benefits patients.

In addition to its core themes, the BRC is supporting ‘crosscutting technologies’ that will benefit translational research in all fields. Non-invasive imaging using ultrasound, for example, plays an increasingly important role in diagnosis and in assessing the effectiveness of interventions: it is one of the key areas of research in the new Institute of Biomedical Engineering that will occupy the same building as the Institute of Cancer Medicine. Engineers have also worked with emergency physicians to produce a computer-based system that monitors patterns in patients’ vital signs in order to produce a single index of their state of health. Building up cohorts of patients with chronic diseases, each carefully profiled, is essential in order to evaluate the effectiveness of treatments. Improved technologies for rapid genetic analysis make it easier to apply new knowledge about the genetic basis of disease in a way that benefits patients.

Professor Buchan is keen to extend his philosophy of the mutual dependence of research, training and healthcare provision beyond the remit of the BRC and throughout both health service and University departments. ‘If you sign up to the idea that this is the best way to treat patients,’ he says, ‘then everything you do, whether it’s new buildings, new appointments or new research programmes, must be about all three.’